January 26, 2021

Antidepressants are widely used for the treatment of back pain, sciatica, and hip and knee osteoarthritis. A study out this week in the prestigious British Medical Journal showed that this isn’t a good idea.

Antidepressants are the 4^th largest prescription medicine in the United States. Common brands include Pristiq, Cymbalta, Fetzima, Effexor, Elavil, Pamelor, Zoloft, Welbutrin, and Prozac. Used primarily for mood and sleep disorders, they are often prescribed for relief of back pain symptoms. About 1 in 4 Americans suffer from low back pain in any 3 month period, making it the most common type of pain.

The investigators looked at 33 studies of over 5000 patients to see how well antidepressants lowered pain levels and disability for several conditions after 3 months of use. They found that there was no benefit for back pain. There may be a slight benefit for those suffering from osteoarthritis or sciatica (pain going down the leg). These medications did show few serious side or adverse effects.

The safest and most effective solutions for chronic back pain, sciatica, and many forms of osteoarthritis are non-drug ones. Chiropractic care, exercise, and deflame nutrition programs that we offer in our office help many people suffering from these conditions.

Reference: Ferreira Giovanni E, McLachlan Andrew J, Lin Chung-Wei Christine, Zadro Joshua R, Abdel-Shaheed Christina, O’Keeffe Mary et al. Efficacy and safety of antidepressants for the treatment of back pain and osteoarthritis: systematic review and meta-analysis BMJ 2021; 372 :m4825